QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Home | Help | Feedback | Subscriptions | Archive | Search | Table of Contents

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (58) Citing Articles via Google Scholar Google Scholar Articles by Tanenbaum, S. J. Search for Related Content PubMed PubMed Citation Social Bookmarking                   What's this?

Knowing and Acting in Medical Practice: The Epistemological Politics of Outcomes Research

Recent health care policymaking favors outcomes research as a response to the putative ineffectiveness, as well as the undeniable expense, of American medicine. This small-scale ethnographic study conducted in a department of internal medicine evaluates claims that probabilistic knowledge will improve clinical practice. It finds that physicians are primarily determinists and that although they reason probabilistically in some instances, they rely on personal experience over research data at these times; that doctors view outcomes research as useful but not definitive and in no way immune to the social influences on medical knowledge generally; and that their mix of determinism and probabilism is well suited to the nature of medical work. The recent ascendancy of outcomes research is as much political as scientific, empowering the research community relative to practicing physicians, lending medical legitimacy to payer-promulgated practice guidelines, and creating additional clinical work around a false standard of medical certainty.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. J. Tanenbaum Pay for Performance in Medicare: Evidentiary Irony and the Politics of Value Journal of Health Politics Policy and Law, October 1, 2009; 34(5): 717 - 746. [Abstract] [PDF]

				S. V. Arnold, C. Decker, H. Ahmad, O. Olabiyi, S. Mundluru, K. J. Reid, G. E. Soto, S. Gansert, and J. A. Spertus Converting the Informed Consent From a Perfunctory Process to an Evidence-Based Foundation for Patient Decision Making Circ Cardiovasc Qual Outcomes, September 1, 2008; 1(1): 21 - 28. [Abstract] [Full Text] [PDF]

				I. Shaw, K. M. C. Smith, H. Middleton, and L. Woodward A Letter of Consequence: Referral Letters From General Practitioners to Secondary Mental Health Services Qual Health Res, January 1, 2005; 15(1): 116 - 128. [Abstract] [PDF]

				J. R. Matthews Practice Guidelines and Tort Reform: The Legal System Confronts the Technocratic Wish Journal of Health Politics Policy and Law, January 1, 1999; 24(2): 275 - 304. [Abstract] [PDF]

				S. J. Tanenbaum Health Accounts and Communicative Power Journal of Health Politics Policy and Law, January 1, 1997; 22(1): 223 - 230. [PDF]

				R. L. Russell and D. E. Orlinsky Psychotherapy Research in Historical Perspective: Implications for Mental Health Care Policy Arch Gen Psychiatry, August 1, 1996; 53(8): 708 - 715. [Abstract] [PDF]

				A. L. Hyams, D. W. Shapiro, and T. A. Brennan Medical Practice Guidelines in Malpractice Litigation: An Early Retrospective Journal of Health Politics Policy and Law, June 1, 1996; 21(2): 289 - 313. [Abstract] [PDF]